MRCP2-4201

MRCP2-4201

A 20-year-old student came to the clinic complaining of sudden onset of left-sided chest pain and difficulty breathing. He had a history of cardiac surgery during childhood and smoked ten cigarettes a day. He denied any use of alcohol or illicit drugs. He had recently returned from a trip to Thailand ten days ago.

During the examination, the patient appeared tall and thin with no signs of clubbing or lymphadenopathy. He did not show any signs of cyanosis, but had a resting tachycardia and an audible click during expiration. What is the most likely underlying diagnosis?